MRI Findings in Axial Psoriatic Spondylarthritis

Abstract

Psoriatic arthritis is a significant medical condition with a high prevalence, a wide variety of non-specific symptoms, and a high degree of overlap with other spondylarthritis disorders, particularly ankylosing spondylitis. Hence, knowledge of the magnetic resonance imaging (MRI) manifestations and a multidisciplinary strategy are required for the better management of these patients. We searched publications from the last 10 years and focused on the most relevant ones which discussed the classification criteria, the MRI characteristics of axial psoriatic arthritis, the importance of MRI for follow up, and the reliability of skin and synovial biopsy. Axial spondylarthritis can be diagnosed and followed up on using the well-established MRI technique and, additionally, a biopsy. The analysis and concordance between them can provide new directions for future studies.

Keywords: ankylosing spondylitis; magnetic resonance imaging; psoriatic arthritis; skin biopsy.

Figure 2

Treatment guidelines for PsA.

Figure 1

PRISMA flow chart of our study research.

Figure 3

(A) Sagittal STIR, (B) T1-weighted sequence. Images show Romanus lesions as tiny subchondral bone marrow oedema (hyperintensities) in the antero-superior corners of lumbar vertebral bodies on STIR and, after the active phase, residual fatty transformation in the same regions on T1.

Figure 4

(A) Coronal and (B) axial STIR sequences show extensive subchondral oedema involving the sacroiliac joints, mainly on the right side and in the inferior regions, consistent with asymmetric active sacroiliitis in a patient with psoriasis.

Figure 5

(A) Coronal and (B) axial T1-weighted sequences of the sacroiliac joints demonstrate subchondral sclerosis and erosions, predominantly on the right side, in the same patient as in Figure 4, consistent with sacroiliitis grade III.